摘要
目的探讨替罗非班用于介入治疗的大动脉粥样硬化型缺血性脑卒中(IS)患者的可行性。方法纳入2022-03—2023-09中国人民解放军联勤保障部队第九〇〇医院的92例大动脉粥样硬化型IS患者,随机分为对照组(n=46)与观察组(n=46),对照组采用介入治疗,观察组在介入治疗的基础上采取替罗非班治疗。比较2组神经功能、血小板功能、血脂水平、日常生活能力、安全性及治疗效果。依据治疗效果将患者分为有效组与无效组,采用Logistic回归模型分析预后的危险因素。结果治疗后观察组NIHSS评分(5.13±1.26比6.81±1.73)、mRS评分(1.97±0.51比2.58±0.72)明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,与对照组相比,观察组S-100β、NSE偏高,NGF偏低(P<0.05);观察组血小板功能指标优于对照组(P<0.05),TC及TG均明显低于对照组(P<0.05)。与对照组比,观察组治疗后BI评分明显更高(P<0.05)。2组不良反应发生率(8.69%比6.52%)无统计学差异(P>0.05)。观察组与对照组有效率分别为97.83%、86.96%,2组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析表明年龄、发病至溶栓时间及高血糖为影响大动脉粥样硬化型IS的独立危险因素。结论替罗非班对介入治疗的大动脉粥样硬化型IS的疗效确切,能够显著改善病情,减轻患者痛苦,安全性高。
Objective To investigate the feasibility of tirofiban in the treatment of large artery atherosclerosis ischemic stroke(IS)after interventional therapy.Methods From March 2022 to September 2023,92 patients with large artery atherosclerosis IS were enrolled and randomly divided into control group(n=46)and observation group(n=46).The control group was treated by interventional therapy,and the observation group was given tirofiban on the basis of interventional therapy.The neurological function,platelet function,blood lipid levels,safety and therapeutic effects between two groups were compared.According to the treatment effect,the patients were divided into effective group and ineffective group,and Logistic regression analysis was used to identify the risk factors affecting the prognosis.Results After treatment,NIHSS and mRS scores in the observation group were significantly lower than those in the control group(5.13±1.26 vs 6.81±1.73,1.97±0.51 vs 2.58±0.72,respectively),and the differences were statistically significant(P<0.05).After treatment,S-100βand NSE were higher and NGF was lower in the observation group than those in the control group(P<0.05).After treatment,compared with the control group,the platelet function index of the observation group was better(P<0.05).After treatment,compared with the control group,TC and TG in the observation group were significantly lower(P<0.05).Compared with the control group,the observation group had significantly higher BI score after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(8.69%vs 6.52%,P>0.05).The effective rate of the observation group was higher than that of control group,there was a significant difference(97.83%vs 86.96%,P<0.05).Multivariate Logistic regression analysis showed that age,the time from onset to thrombolysis,and hyperglycemia were independent risk factors for large artery atherosclerosis IS.Conclusion Tirofiban is effective in the interventional treatment of large artery atherosclerosis IS,can significantly improve the condition,alleviate the patients pain,and has high safety.
作者
沈丰丰
李华
SHEN Fengfeng;LI Hua(Cangshan Campus,the 900th Hospital of the Joint Logistics Support Force of Chinese People’s Liberation Army,Fuzhou 350007,China)
出处
《中国实用神经疾病杂志》
2025年第10期1261-1266,共6页
Chinese Journal of Practical Nervous Diseases
关键词
缺血性脑卒中
大动脉粥样硬化
血管内介入术
替罗非班
安全性
危险因素
Ischemic stroke
Large artery atherosclerosis
Intravascular intervention surgery
Tirofiban
Security
Risk factors
